Our nervous systems are equipped with an alarm system, much like a fire alarm, that alerts us to danger. This system is triggered by impending danger, and it instantaneously prepares our body to “fight or flee” and ultimately protects us from harm. For some individuals, the alarm system rings at inappropriate times, when there is no obvious danger. Imagine sitting at home, watching television, and, from out of nowhere, this alarm reaction occurs. A panic attack is defined as a sudden rush of intense fear or dread, which usually goes along with several of the following physical symptoms and thoughts: shortness of breath or smothering feelings, dizziness, feeling faint or unsteady, racing or pounding heart, trembling or shaking, sweating, choking sensations, nausea or abdominal distress, feelings of being detached or things seeming unreal, numbness or tingling sensations, hot flashes or cold chills, chest pain or discomfort, fears of going crazy, fears of losing control, and fears of dying. In a panic attack these symptoms are not the result of a real medical condition, such as illness, too much caffeine, or alcohol or drug intoxication. Individuals who experience unexpected alarms develop a fear of these sensations.

Panic disorder is distinguished from other anxiety disorders by the unexpected nature of the alarm reactions as well as the continuing anxiety about their return. Worry about the return of panic often leads to the avoidance of situations in which help may not be available or from which escape is difficult, should a panic attack occur. The types of situations avoided may include crowded shopping malls, theaters, highway driving, elevators, walking alone, or traveling far from home. This is known as “agoraphobic avoidance.” In contrast, the occasional panic attack experienced by people with other types of anxiety problems is rarely a major source of concern, and rarely leads to significant avoidance behaviors.